The study ended with the participation of 30 women whose demographic characteristics are shown in Table 1. After analyzing the data, 389 open codes, 14 subcategories, 4 categories, and 2 main categories were extracted, which are described below (Table 2).
Table 1. Demographic characteristics of participants
Variable
|
Dimension
|
Frequency (%)
|
Age
|
<16
|
6(30)
|
16-20
|
16(53.33)
|
20-25
|
8(26.66)
|
Education
|
Illiterate
|
4(13.33)
|
Under diploma
|
14(46.66)
|
Diploma
|
8(26.66)
|
Higher than diploma
|
4(13.33)
|
Residence
|
Urban
|
11(36.66)
|
Rural
|
19(63.33)
|
The age of first marriage
|
<15
|
7(23.33)
|
15-16
|
10(33.33)
|
16-18
|
13(43.33)
|
Type of marriage
|
Forced
|
10(33.33)
|
Traditional
|
12(40)
|
Self-choice
|
8(26.66)
|
Age difference with spouse
|
<5
|
7(23.33)
|
5-10
|
13(43.33)
|
>10
|
10(33.33)
|
Abortion background
|
Yes
|
11(36.66)
|
No
|
19(63.33)
|
Table 2. Main categories, categories, subcategories, and codes extracted from the analysis of interviews
Main categories
|
Categories
|
Subcategories
|
Codes
|
Negative consequences
|
Physical and psychological problems
|
High-risk pregnancies and childbirths
|
unwanted pregnancy, unawareness of how to control fertility, infant mortality, an increase of abortion risk, recurrent abortion, abnormal delivery, postpartum hemorrhage, and short interval between births
|
Physical illnesses
|
blood pressure, underweight, severe headaches, food shortage, delayed physical growth, iron deficiency, and backache
|
Depression and emotional distress
|
yearning for childhood, yearning for adolescence, yearning for love, yearning for studying, remorse for early marriage and remorse for early pregnancy,
depression, suicide ideation, and attempt, feelings of inferiority, and low self-confidence
|
Family problems
|
Dissatisfaction with married life
|
economic, physical, psychological, and sexual violence,
emotional divorce, divorce, and sexual dissatisfaction
|
Experience of having a lot of responsibility
|
responsibility of child-wife, mother-child, and bride-child, being the head of the household, staying in the role of child and being thrown into the adult world
|
Lack of independence in family life
|
powerlessness in decisions for home, powerlessness in decisions for children, and powerlessness in determining family relationships
|
Social problems
|
Social deviance
|
having an emotional/sexual relationship outside the family, a desire to run away from home, and a desire to drink alcohol and smoking
|
Deprivation of social and health services
|
lack of access to necessary health services, lack of access to social services such as counseling centers, lack of social support in society, deprivation of the media, and low knowledge of technology
|
Social Isolation
|
leaving relationships with peers, being locked up at home, interacting with people who are incompatible in terms of age, etc.
|
Deprivation of job and educational opportunities
|
dropouts, unemployment, low literacy and lack of skills
|
Positive
consequences
|
Gaining support and empowerment
|
Receive intra-family support
|
receiving information support, receiving financial support, receiving support for childbirth and childcare
|
Improving living conditions
|
change in her economic status, change in her family's economic status and escaping bad family circumstances
|
Opportunity for progress and empowerment
|
returning to school, taking a job, engaging in favorite skills, self-confidence, and self-efficacy
|
Negative Consequences of Early Marriage: Early marriage posed many challenges for women at various individual, family, and social levels, leading most participants to regret the marriage.
1- Physical and psychological problems: Marriage in childhood endangered women's health and makes them confront with more physical and psychological problems such as high-risk pregnancies and childbirths, physical illnesses, yearning and remorse, and psychological challenges.
High-risk pregnancies and childbirths: It consists of codes such as unwanted pregnancy, unawareness of controlling fertility, infant mortality, an increase of abortion risk, recurrent abortion, abnormal delivery, postpartum hemorrhage, and short interval between births. Most adolescent women had little awareness and knowledge about contraceptives due to the taboo of talking about sexual issues in Iran. These issues were never fully explained to adolescent women, so their knowledge was limited. Therefore, most adolescent women inadvertently became pregnant, and because they had no preparation for this and have not received education for pregnancy in adolescence, they faced many problems that endangered their and child's health.
"Honestly, I didn't want to get pregnant, but I didn't know how to prevent it. There was no one to guide me. I became pregnant very soon." (Participant, 5)
"I have had two abortions. Most of those who get married at a young age have such an experience." (Participant, 14)
"I really wanted to give birth naturally, but I couldn't give birth to my baby, so I had a cesarean section." (Participant, 28)
"For the first four years of my life, I was pregnant all the time and my baby was not born alive. My body had nothing left." (Participant, 17)
"I became very weak after my child’s birth, and I had a lot of problems." (Participant, 30)
Since adolescent women did not have the proper knowledge and skills of contraception, they usually became pregnant unwantedly soon after marriage, and because they were not physically and mentally ready for childbirth, they tackled many problems, which endangered the health of mothers and newborn children, and it may have even led to the death of both.
Having physical illnesses: This subcategory includes the codes of blood pressure, underweight, severe headaches, food shortage, delayed physical growth, iron deficiency, and backache. Some girls who got married in childhood confronted many physical problems and got pregnant, which could affect their health and reduce their quality of life. Most of these girls who got married early were from humble families, and on the one hand, they had financial problems in preparing proper food, and on the other hand, they did not eat nutritious food due to their lack of nutrition knowledge. Therefore, they confronted many physical problems. The pressures of early pregnancy could also exacerbate the disease and physical problems.
"I had my first abortion, then I had a nosebleed two months later. I went to the doctor. They told me that my blood pressure had gone up. Every once in a while, my blood pressure rises, and it bothers me." (Participant, 4)
"I don't know, maybe I'm wrong, but I feel like the marriage made me have a severe headache. I went to a doctor, and he said I had a migraine." (Participant, 10)
"I'm young, but every part of my body is in pain. Sometimes my backache drives me crazy." (Participant, 18)
Girls who got married during childhood had many physical problems after the marriage that could endanger their health and lower their quality of life.
Depression and emotional distress: This subcategory includes the codes of yearning for childhood, yearning for adolescence, yearning for love, yearning for studying, remorse for early marriage, remorse for early pregnancy, depression, suicide ideation and attempt, feelings of inferiority, and low self-confidence. The experience of love and having children is one of the sweetest moments in every woman's life, but most women who got married in childhood did not get this sweet experience, since most of their marriages were traditional and without love and affection. Also, most of these women became pregnant inadvertently with bad conditions accompanied by many problems. Consequently, these conditions caused them to regret and felt that they had never experienced the joy of love and many other things. Also, the fact that many girls were forced to drop out of school after marriage, which made them regret that they did not continue their education in order to have a job. This lack of a job and sufficient literacy caused them to have less self-confidence. These events increased the problems and challenges of adolescent women, while they had neither the training nor the skills to cope with any of these challenges, so in some cases, these women saw no other way but to end their lives and commit the severest and the most violent type of suicide, i.e., self-immolation. Every year, many women in Kermanshah and Kurdistan provinces commit self-immolation due to family and marital problems.
"I never had the childhood which I always yearned for. I always wanted to ride a bike, but they forced me to marry. After marriage, if you ride a bike, everyone will blame you." (Participant, 20)
"When I see some of my friends got married with love and affection my heart breaks, I feel very sorry that I wish I had fallen in love. It's annoying that I can't experience love anymore." (Participant, 30)
"I cry when I hear from some people that the best experiences of their lives are being married and having children because it has been the worst experience of my life." (Participant, 3)
"I regret when I thought I could enjoy my marriage and having children, but because of my early marriage, everything was ruined." (Participant, 1)
"I haven't laughed from the bottom of my heart for a long time. I'm always sad for getting married early. I'm not in the mood for anyone. My sister tells me I’m depressed." (Participant, 12)
"I have decided several times to kill myself and get rid of this life. Once I poured oil on myself, but as soon as I lit the fire, my brother-in-law understood and did not let me kill myself." (Participant, 12)
"My self-confidence is very low. I feel worthless. I don't like to be with others at all. When I want to talk, I mispronounce some words." (Participant, 20)
Child marriage prevents a child from experiencing childhood and adolescence like their peers, and this annoys them in the future. In the case of marriage and pregnancy, which can be a woman's sweetest experiences, the early marriage made them the worst happenings in life. These issues could lead girls who had been married as children to face a lot of yearnings and regrets. Also, when they saw their successful peers who had been educated and had a job, they inevitably compared it with their lives and circumstances and have more regret. Child marriage puts a lot of pressure on women, causing them a lot of psychological harm, and because they have no skills or abilities to solve these problems, it lowers their self-confidence and increases their feelings of inferiority. As a result, it led to depression, and in the end, it could even lead to suicide.
2 - Family problems: Families, in which child marriage is common are more fragile than other families due to their circumstances and face many problems that in some cases these problems can destroy the functioning of that family.
Dissatisfaction with married life: The codes of economic, physical, psychological and sexual violence, emotional divorce, divorce, and sexual dissatisfaction are related to this subcategory.
As previously mentioned, most girls who married in childhood lost the opportunity to continue their education, learn skills, and get a job, and thus, they became financially dependent on their husbands. In some cases, their husbands may have abused this financial dependency, giving women less money and necessities of life, and somehow using economic or financial violence against them. Adolescent women also entered into married life without any skills or education, and in some cases, their husbands may be young and had no skills and training for married life. So women may undergo sexual violence from the beginning. And after marriage, there had some problems in their genitals, as some participants said that on the wedding night, they were bothered and hurt because they or their partner did not know how to have sex. They may also be subjected to physical and psychological violence due to their lack of marital management skills and their poor position in the married life. In some marriages, the age gap between couples was so huge that they had no understanding of each other, so in many cases, either divorce occurred, or they tolerated each other only to avoid the restrictions and problems after getting a divorce. Most women said they did not have a desired married life, which in some cases led to divorce, and if they were still in a relationship, there was an emotional separation and sexual dissatisfaction.
"I’m not financially independent. Every time I ask my husband for money, he annoys me a lot to give me money. Sometimes he forces me to stop another request for the money he gives me." (Participant, 14)
"It's been less than two months since our marriage, my husband gave me a beating. He is very violent. He often beats me for trivial things."(Participant, 15)
"I've heard a lot of insults from my husband. He says a lot of ugly things to me. Sometimes he yells at me in the family gathering and says ugly things to me." (Participant, 1)
"I didn't know much about sex in the beginning, so I didn't know how to please my husband. My husband sometimes got angry and told me I didn't know anything, and he would do whatever he wanted, even if I wasn't happy." (Participant, 8)
"I was very annoyed the first night and that's why I never enjoy sex anymore. Every time we do this, I get more annoyed. My sister, who got married early, says like me, she doesn't enjoy it at all." (Participant, 25)
"My husband and I don't understand each other at all. Sometimes we don't talk for ten minutes in a week. If it weren't for my baby, I would separate." (Participant, 23)
"I had a disagreement and argument with my husband from the very beginning of my life. He said “you don't know anything”. Our life wasn't good at all. We fought with each other all the time and I had to divorce him." (Participant, 12)
"My husband and I have a big age difference, so we can't satisfy each other sexually." (Participant, 6)
Girls who married as children had less awareness, skills, and power in life, as well as less knowledge of social rights, sexual issues, and married life. Thus they were abused by their husbands. Also, as they grew up in a traditional society where talking about sex had always been taboo, and they had not been properly familiar with sex in the education system, they did not have a proper understanding of sex and could not meet the needs of their husbands. Therefore, they were sexually abused and may even suffer severe injuries. Some of the participants got married by force or due to poor social and economic conditions and without love and interest and had a big age difference with their husbands. So, they experienced many problems in life and were not satisfied with their married life.
Experience of having a lot of responsibility: The responsibility of child-wife, mother-child, and bride-child, being the head of the household, staying in the role of child, and being thrown into the adult world were among the codes of this subcategory. Many wives, even though they were still children, were forced to take on various responsibilities that put a lot of pressure on them. In fact, teenage girls were forced to take on responsibilities as a wife for which they were not yet prepared. But this was not the end of the story, because they added another responsibility with their early pregnancy. If they were unlucky that in the event of the death of their husband, they had to take on the responsibility of the head of the household, and taking on all these responsibilities without receiving any training and support can endanger their health and even their future.
"When I got married, I was very young. I used to watch cartoons at my father-in-law's house. My husband argued with me many times about this. He said, 'Why are you behaving like this? You grew up. You mustn’t watch the cartoon.' "(Participant, 26)
"We lived with my husband's family. They expected me to behave like a perfect woman, but I didn't know many things. Whenever they had guests, they would argue with me a lot, saying my behavior was wrong." (Participant, 2)
"When my husband died, I was 17 years old and had a two-month-old baby. I had to be both a father and a mother to my child while I was still a child." (Participant, 4)
"It wasn't until a month after we got married that I realized I was pregnant. I got confused; I didn't know what to do. I was just crying. I was a child myself. When my baby was born, I couldn't protect her at all." (Participant, 23)
"I was a child myself, but I was expected to be both a good wife and a good mother. No one understood me." (Participant, 29)
"I feel like I didn't have adolescence and youngness. As soon as I came to my realization, I saw that I was thrown out of my childhood world into the adult world. I didn't understand anything as a teenager and a young person, and that bothers me." (Participant, 1)
With early marriage, children were forced to take on several different responsibilities at the same time. Each of these responsibilities had its own importance, and because of having no training for any of these roles, so they were under a lot of pressure.
Lack of independence in family life: This subcategory consists of codes of powerlessness in decisions for home, powerlessness in decisions for children, and powerlessness in determining family relationships. When women got married in childhood, they had very little power in their married life because they did not know many issues related to life. Also, because they lived with the husband's family, in many cases, they interfered in the young couple's life under the pretext of instructing the issues of married life so that they made the final decision in their personal issues and decide for them what to do and what not to do. This may happen in all stages of life and is not only related to the early years of married life. Several participants stated that even after having children, the husband's family had made the main decisions in their lives.
"My husband makes his decisions without telling me anything. He hasn't asked my opinion at all." (Participant, 8)
"My mother-in-law makes a lot of decisions for me. She says, “You are very young. You don't have much experience”. (Participant, 4)
"I can't even wear my favorite clothes; I didn't want to have children at all, but my husband's family kept on me about it, so I had to do it." (Participant, 2)
"When you get married as a child, everyone likes to interfere in your life because they think you don't understand anything of life." (Participant, 30)
"I wanted to name my daughter as I like, but my husband and his family chose something else. They didn't ask me if I like this name or not." (Participant, 18)
Due to child marriage, girls become more vulnerable in their married life and have less power of bargaining and negotiation to reach their goals. There should also be space for others to interfere, as adults think that the young bride does not have enough experience and should be trained to live, so they allow themselves to interfere in their most personal matters.
3- Social problems: In addition to individual and family problems, young women also faced problems and limitations in society that could make living conditions more difficult for them.
Social deviance: This subcategory includes the codes of having an emotional/sexual relationship outside the family, a desire to run away from home, and a desire to drink alcohol and smoke. Since most women married in childhood out of compulsion or unawareness, and it was rare for them to marry out of love and affection, they faced difficulties in the married life because they were not emotionally supported in the family. Moreover, they wanted to fill this emotional void by building up emotional or even sexual relationships outside the family. Child marriage could lead to other high-risk behaviors, such as smoking and alcohol consumption. In rare cases, women resorted to alcohol and smoking to endure post-marital conditions and to reduce or alleviate their pain. Of course, sometimes, due to their young age and big age difference with their husbands, they had less power in the family, so if their husbands were addicted to drugs, they may have forced young women to use drugs.
"My husband and I have a big age difference. We cannot understand each other at all. We also have sexual problems. My husband cannot satisfy me much, so I sometimes have sex with other people to satisfy my sexual needs" (Participant. 7)
"I'm 22 years younger than my husband. We don't understand each other at all. I often go on social networks and talk with other people." (Participant, 17)
"For the first few years of my life, I just cried. My husband is a smoker. I started smoking, firstly he disagreed but then he didn't say anything to me." (Participant, 2)
"In order to think less about my life and grieve less, I sometimes drink. We always have it in the fridge, my husband drinks a lot." (Participant, 14)
Marriage in childhood causes many problems for girls. In some cases, these girls were drawn to social deviance to get rid of these conditions or to endure them.
Deprivation of social and health services: This subcategory consists of the codes of lack of access to necessary health services, lack of access to social services such as counseling centers, lack of social support in society, deprivation of the media, and low knowledge of technology. Adolescent women needed a lot of social and health services after marriage due to the physical condition of pregnancy and the psychological pressures of married life in order to cope with the new situation. However, in the study area, there was no special service for these women and they were left alone and helpless. This could make the process of adapting to the new life more difficult for them. Also, most married teenage women were low literate due to early marriage and dropped out of school. In many cases, they were not able to use modern technologies, so they were not familiar with the internet. Therefore, they could not use its contents to raise their awareness and knowledge of the issues of the married life.
"They do not provide us with any health services. Even when we become pregnant, there is no organization to support us." (Participant, 3)
"We face many problems during and after pregnancy, but the government and other organizations do not help us at all, and sometimes we are even reprimanded in hospitals." (Participant, 17)
"When I got married, I didn't know many things. There was no special place for me to ask for their help and advice." (Participant, 11)
"I studied until the third grade of elementary school. I don't know much about education. I can't even work with new phones. I don't know anything about the Internet, too." (Participant, 15)
"I and all those who got married at a really young age have our own special needs, but there is no special place for us." (Participant, 29)
Despite many social and health needs of girls who had experienced early marriage, there was no institution or organization in the society to support these girls and no special training and privileges were provided for them. Lack of sufficient literacy and media skills and abilities was another problem for these women, which made them not even know how to find the answers to their questions.
Social isolation: This subcategory includes the codes of leaving relationships with peers, being locked up at home, and interacting with people who were incompatible in terms of age, etc. According to the culture and customs of the society under the study area, when a woman got married, she needed to devote all her time and attention to her family and spent less time with her friends, especially her single friends. This issue caused girls who get married early to stay away from their peers. Likewise, when they dropped out of school due to marriage and became pregnant, they had to stay at home full time and raise their children. Therefore, most of these women were socially isolated, and their circle of social relationships got limited. This issue can cause many psychological and social problems for them.
"When I got married, I cut off most of my school friends. I had nobody left. I felt very bad." (Participant, 6)
"My husband doesn't like me to be in a relationship with my single friends. I had nobody left to confide in." (Participant, 20)
"In my husband's relatives, those who are married are all too old, and I cannot be intimate with single people. That's why I have more relationships with people who are older than me. We cannot understand each other. I hate having to deal with people who are older than me, and we don't understand each other. "(Participant, 17)
"After marriage, I had to stay at home all the time. My husband is the driver of a big truck. He is at home for more than 4-5 days. When he leaves, I have to stay home. Because he dislikes I go somewhere alone. "(Participant, 26)
Girls who married early fell out of the world of their peers and were forced to have relationships with people who had a large age difference from them. This made them less inclined to have relationships with others, which in turn led to more social isolation. Also, it was not culturally acceptable for married women to associate with single girls. So, girls who have early marriages will soon be separated from their peers.
Deprivation of job and educational opportunities: This subcategory includes the codes of dropouts, unemployment, low literacy, and lack of skills. Most participants stated that after marriage, they were forced to drop out of school, or they had studied for a short time. So, they did not have the opportunity to learn a skill due to marrying early and getting busy with life and child care.
"I was 16 when I got married, and then I had to drop out of school. My husband used to say, 'Why does a woman want to study!?' "(Participant, 2)
"I got married as a child. I didn't know anything. Now that I want to have a job, I don't have any skills. I wish I hadn't gotten married." (Participant,3)
"I was good at tailoring. I was learning fashion designing with my aunt. She always told me that I had the best talent. But when I got married, I could continue my work only for a month. Then I knew that I was pregnant. I got busy with child care and quit my work. "(Participant, 19)
Many children are forced to drop out of school after marriage and are forced to stay as housewives having no financial independence because they are neither educated nor skilled.
Positive Consequences: Marriage in childhood is not only associated with negative consequences, but also in some cases, these marriages can be useful and improve the lives and health of young girls, or at least save them from the bad conditions of the paternal family.
1- Gaining support and empowerment: This category consists of subcategories of receiving intra-family support, improving living conditions, and the opportunity for progress and empowerment.
Receiving intra-family support: This subcategory includes the codes of receiving information, receiving financial support, receiving support for childbirth and childcare. Young brides enjoyed a lot of prestige in their husband's family, receiving more attention and support due to the existing social and cultural norms of the study area. In some cases, where the bride and groom were both very young, their families, and especially the groom's family, had a duty to fully support them. The young couples received more financial support, and in some cases, they were paid living expenses for years. Paying living expenses for a young couple can relieve them from the worries of doing a job, and thus, they can continue their education. Besides, young couples may have very little sexual knowledge at the beginning, so their family members, especially the women can provide the young bride the information about the way of having sex, etc. Of course, providing this kind of information has decreased in recent years because, with the expansion of internet access, young couples can find such information they need. In most cases, young brides, who had lived with the husband's family for a few years, received more supports from his family during pregnancy and childbirth. Because most of the child-related work was done by the mother-in-law or sister-in-law. However, if the bride was not young, none of this support may be provided. Thus, such situations can be considered as one of the positive consequences of early marriage for girls.
"I didn't know anything about married life, but my sister-in-law, who had an early marriage, explained everything to me before the wedding."(Participant, 13)
"My husband and I were both very young, so my father helped us, and my husband's family didn't let us be under much pressure. They said, 'You're too young, we have to take care of you.' "(Participant, 16)
"When I told my mother-in-law that I was pregnant, she got very happy. She told me not to worry at all, and she would take care of my baby herself. Indeed, it was as she said. She did everything related to my baby until my baby reached 3 years old. "(Participant, 9)
Young couples were supported more by their families after marriage, as early marriage was accepted by the parents in the study area.
Improving living conditions: The codes of change in her economic status, change in her family's economic status, and escaping bad family circumstances fall into this subcategory. There were a lot of demands for marriage with adolescent girls. Some of these girls who lived in families with poor economic and social conditions could save their lives and their families’ lives after marrying the people who had better economic and social status. This change in their economic and social status, in some cases, may lead to their inner satisfaction with early marriage.
"I lived in a poor family. When I got married, my situation changed a lot. I had things I couldn't even dream of. It's true that my husband is 10 years older than me, but I'm very happy with my life." (Participant, 7)
"My father was an addict, and he sold drugs. Our house was always full of addicts. My uncle was always very worried that my father's friends would hurt me. That's why he took me for his son. He supported us a lot. We have the best life now. Maybe if I hadn't gotten married sooner, my life would have been ruined, and I would have killed myself. "(Participant, 27)
In some cases, girls living in economically and socially disadvantaged families made significant changes to their lives with early marriage. The early marriage made it easier for them to achieve better conditions, so this made them happy and satisfied.
Opportunities for progress and empowerment: This includes the codes of returning to school, getting a job, engaging in favorite skills, self-confidence, and self-efficacy. Some women who dropped out of school in their singlehood due to financial and social limitations were able to resume their studies after marriage with the support of their husbands and even be accepted to university. This led to their inner satisfaction. Some of the other participants were able to pursue their favorite hobbies and activities, gain skills in various fields and have a job that was not possible for them in their single life due to their financial and social restrictions.
"Before I got married, I dropped out of school. After marriage, my husband helped me to continue my study. He was the teacher of the village. My mother-in-law helped with the housework. That's why I spent most of my time studying. I was accepted in the entrance exam of the university of medical sciences. Maybe if I hadn't gotten married, I wouldn't have thought about studying. "(Participant, 21)
"Before I got married, I really wanted to be a hairdresser, but my family didn’t allow me. After marriage, my husband took me to hairdressing courses. Now I have a hair salon, and I am really happy with my life. "(Participant, 7)
"When my first child was born, I felt very good. I felt I grew up. I enjoyed a lot to see that I could take care of my kid. I did my best to take care of her in the best possible way. When all my husband's family members praised me, my self-confidence increased." (Participant, 22)
"My husband is a good person and helps me a lot to be someone for myself. When I finished my sewing class and got a shop, I felt good about myself. I feel like I can do anything well." (Participant, 21)
"I enjoy seeing everyone count on me and get help and advice from me in their work, especially when my husband's family or my family is complimenting me in front of others." (Participant, 13)
Some of the participants grew up in families that put a lot of restrictions on them and prevented them from doing what they loved to do, but by getting married, these restrictions were removed and they pursued their favorite interests and skills, and this issue has led to the flourishing of their talents. Some other women who were able to cope with life's problems after marriage also felt good, which made them more satisfied.